Effectiveness of sport-based HIV prevention interventions: A systematic review of the evidence

Kaufman, ZA; Spencer, TS; Ross, DA AIDS and Behaviour, 2012; Vol 17 (3) 987-1001 link.springer.com/article/10.1007%2Fs10461-012-0348-1

Interest in sport as a tool for behavioural HIV prevention has grown substantially in the past decade. Dozens of organisations now use sport-based HIV prevention (SBHP) approaches. The concept of SBHP is based on the idea that sports role models, activities and metaphors can increase knowledge, improve attitudes and change behaviours related to HIV.

The purpose of this systematic review is to synthesize findings from all published and unpublished literature on SBHP interventions in order to:

  • determine whether current evidence supports the effectiveness of SBHP
  • identify gaps, weaknesses and limitations of existing research in order to guide future research in this area

The authors employed a two-pronged search strategy to identify studies. They then appraised these studies using an adapted Newcastle-Ottawa Quality Assessment scale. They carried out random effects meta-analyses for overall effects on:

  • HIV related knowledge
  • stigma
  • self-efficacy
  • reported communication
  • reported recent condom use


  • Of the 18 studies assessing HIV-related knowledge, 15 reported an overall positive effect
  • Of the 15 studies finding a positive effect, 10 had very strong evidence of effect
  • 8 of 11 studies assessing stigma reported a positive effect
  • 3 out of 5 studies reported increases in self-efficacy
  • 5 of 8 studies reported an effect on other HIV-related attitudes and life skills
  • Of the 5 studies assessing reported communication, 4 studies found a positive effect on reported HIV-related communication (2 with strong evidence, 1 with unclear evidence) and 1 multi-country study found no effect
  • Of the 6 studies assessed an effect on reported sexual behaviour, 5 reported positive effects on at least 1 behaviour while one study found no effect
  • 4 out of 4 studies found evidence of a positive effect on condom use

Generally, the review found encouraging evidence for some short-term effects but relied predominantly on low quality studies. More rigorous research on SBHP is needed to objectively assess effectiveness. Notably, it also found that randomised controlled trials could play an important role in guiding policies, strategies, and funding related to SBHP.

Grassroots Soccer

This model is rooted in Social Learning Theory, using interactive teaching methods and role models with an aim to increase knowledge, improve attitudes and self-efficacy, and ultimately change sexual behaviour to reduce HIV incidence.

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